Program Offers Women Drug-Free, All-Natural Childbirth

Audio

Aired 10/7/09

Most women who give birth in the U.S. do so with the help of pain medication and other medical interventions. A program at UCSD Medical Center in Hillcrest is devoted to helping women have an all-natural, drug-free birth. This month, the program celebrates its tenth anniversary.

A few hours earlier, Jean Ries was in the throes of labor. But unlike most other moms-to-be in the U.S., Ries didn't have pain medication, and she didn't have a drug to speed up her labor. Ries didn't even spend much time in bed.

"I didn't lie down at all," Ries says. "I'd like lie down once and I was totally uncomfortable. I pretty much was standing, and walking, and in a squat on the floor, took two showers, yeah, I mean I was all over the place.

Midwife Karen Perdian directs the Birth Center. She says in the typical labor and delivery unit, women are usually confined to bed. They're strapped up to a monitor.

In contrast, women who have babies in the Birth Center can pretty much call their own shots.

"She can be in whatever position works for her," says Perdian. "She can soak in the tub, get in the shower, eat and drink, move around, and as long as she is healthy, and the baby is fine and the labor is normal, we can sit back and allow her to have what she wants."

There are no doctors in the Birth Center. It's run by midwives and nurses. The center is the only hospital-based program of its kind on the west coast.

Midwife Karen Ruby Brown has worked at the center for six years. She says their philosophy is childbirth is a natural phenomenon. And pain is a normal part of it. Brown says people often confuse pain with suffering.

"And the pain of childbirth can be considered similarly to the pain of running a marathon, or the pain of climbing a tall mountain," Brown says. "There's a way in which the process of going through that work, integrates into the very being of the mom. And it creates a different kind of experience than someone who maybe took the tram to the top of the mountain."

Brown points out staff like to let labor take its course, without the aid of drugs. But that doesn't mean they just sit around and do nothing.

"If we notice a complication is happening and we need participation from mom and the nurse, we will shout out those orders," Brown points out. "We will instruct the nurses what to do, we will instruct the mom what to do. If a mom needs to for example change position to help get a stuck baby out, I will bark an order at her. I will say, get in the bed right now and bring your legs back."

If a woman's blood pressure goes to dangerous levels, or the baby's heart beat becomes worrisome, the mom will be taken down to the Labor and Delivery unit.

But by and large, most women who want to have an all-natural birth can do so.

A woman named Lupita breathes through her contractions as midwife Brown rubs her back. They walk around the hallway, then step into a private room. Lupita's mother, sister, and husband stand by.

Lupita sits on an exercise ball for a while, and finally gets on the bed.

And not a moment too soon.

"Waa, waa!" It's a girl.

Kelly Frederick had her first child in the Birth Center, and her second in the Labor and Delivery Unit.

She says having a baby in the Birth Center is more natural.

"It's treated as a normal occurrence, and it's treated as something that a woman is able to do on her own, and not as though being pregnant, there's something wrong with you," Frederick says. "There's nothing inadequate about a woman's body, and her ability to give birth to her baby."

Sometime over the next few months, the Birth Center will help bring its 3,000 baby into the world.

Great. One more way in which women are made to feel guilty about needing help in motherhood: by poo-pooing labor and delivery and treating such medical assistance as cheating.

These so-called natural birth centers aren't for mothers whose water has broken without labor. In those instances, all the breathing, standing, showering, and walking will induce labor.

You know, I wait for the day when KPBS starts to act consistantly. On the one hand, you denegrate us pro-lifers for actually treating the baby as, well, a baby, and, then, on the other hand, you denegrate the very medical profession which you earlier lionize for killing the baby because medicine is used to actually help both mother and baby survive child birth.

The point is that women should know that they have choices about how they want to give birth. This Birth Center is not right for everybody, but many women with a normal, low-risk pregnancy are thrilled to find out about options they didn't previously know existed. Or, they may just want to be cared for by midwives, but in the Labor & Delivery Unit within the same hospital at UCSD. A woman can even change her mind mid-way through her labor and transfer to L&D. As far as women "needing help in motherhood" I think you may have missed the point, Matthew...the Birth Center offers more kinds of help, and support and more intensive, one-on-one care than you'll find in many places (especially important when things don't go as expected, like water breaking ahead of the start of labour.).

Matthew...I don't know why you bothered. You started out making a point and then - well, I don't know what that was.

But I digress. I am not yet a mother, but I am sick and tired of these "natural birth-ers" getting up on their high horses and implying that a woman who chooses medication to lessen pain is weak because she chooses to "take the tram to the top of the mountain". That's as bad as women who give birth vaginally making disparaging remarks about women who choose C-sections. Child birth is no walk in the park any way you do it; no one is taking the easy way out.

Ok seriously, why are you even reading/listening to a segment on natural birth if all you are going to do is harp on it?

Matthew, inform yourself before you open your mouth. My water broke before I went into labor, and I DID walk and shower, etc, which DID progress my labor, and 24 hours after my water broke, I had a wonderful, natural birth at UCSD Birth Center. And if you looked into it at all, you would realize the Birth Center is ONLY for low risk, normal and healthy pregnancies. If mother or child is at any time in danger or needs specalized care (or even if she changes her mind and just wants an epidural, etc.), she is transfered to Labor & Delivery immediatly.

Margmoore, no one is up on their high horse... just as (to borrow from the article) someone who hikes to the top of the mountain doesnt put down an elderly person who has to take the tram to get there. Certainly there are circumstances where its not possible to hike the mountain, and there are people who would just rather take the tram even if they could hike it, but the point is, that you CAN hike it, and there are places like UCSD's Birth Center for those women who want to and are able to, like I did. And if you cant handle a 20 second clip of a baby being born, maybe you aren't meant to experience the wonder and beauty of childbirth yourself.

I'm a mother and applaud women who decide for themselves what is best for them. If you think natural childbirth is empowering, fine by me. My disagreement is with those women who advertise it or promote it as "the right way". The whole thing about the need to feel pain to make it real is nonsense to me. Motherhood is a daunting task as it is. We were 'designed' to give birth so you won't be getting extra points for going one way over the other if you get to choose.

It usually is the 'natural birth advocates' the ones who get more passionate and defensive about their accomplishment as if they needed the recognition or the pat in the back. I rather celebrate women for who we are, not the pain we have to go through.

What I found so moving about the aired interview was the small part where we heard the baby being born. It was so quiet, so normal! No yelling, no frenzy, just "Good, here we go, there's your baby." Just a lovely birth, not a traumatic medical emergency.

Reminder: We do appreciate a diversity of opinions, but they need to be discussed in a respectful manner. We expect to see disagreements on the issues, but it's no longer productive when people turn to insults. In the end, insulting those who don't agree with you only weakens your credibility.

Please keep it above the belt; we will remove offending comments: "KPBS expects users to be civil and courteous even when in disagreement. Personal attacks, profanity, harassment based on class, disability, ethnicity, gender, national origin, religion, race, sexual orientation, or other offensive conduct will not be permitted."(http://www.kpbs.org/about/terms-service/#rules-of-use)

We love the passionate discourse, but don't want to see any low blows. Thank you for keeping this in mind as you comment.

This story was about a specific place, the UCSD Birth Center, which offers a specific care option. It was not about 'natural' birth vs....what, 'unnatural' (?) birth. I did not state that the experience of hiking that tall mountain was "better" than taking the tram, only "different." Personally, I love a good tram ride. The hikers whom I see below me are having a different experience. Is it better? No. It's different.A little fact check: The UCSD Midwives take care of patients on both the Birth Center, and on Labor & Delivery. In fact, 2/3 of our patients are on L&D for various reasons: the desire for anesthesia, or a complication that risks them out of the Birth Center. Regarding anesthesia, we are often the ones who suggest an epidural for women who, after trying what we can offer on the Birth Center (including, yes, IV narcotics) are not coping well with the pain. Kenny asked us if we considered such a transfer a failure, and we replied, "of course not." And it's true; we don't. One thing that's very nice is that, almost always, we will still be able to take care of the woman who does transfer to L&D, which means continuity of care.

What the Birth Center offers–FOR LOW-RISK, HEALTHY WOMEN WHO WANT IT–is the opportunity to labor and birth physiologically, without anesthesia, in positions of their choice, without being connected to the monitor, and without a routine IV. Why does this option, this OPTION, get so many people riled up? How does it define the midwives who are supportive of that care as an option as, "natural birth-ers" getting up on their high horses and implying that a woman who chooses medication to lessen pain is weak..." If we considered the choice of medication to be a sign of weakness would we be attending so many women on L&D with anesthesia? Where does that come from? Now, that's the more interesting question, in my opinion.

I assisted a woman this morning who transferred from the Birth Center to L&D for an epidural and pitocin to make stronger contractions. We had a great time together. It was a beautiful, delightful, joyful birth, probably one of the best times I've ever had in this profession. Does that sound like a guilt-inspiring lie?

But, I digress.

This story was about the Birth Center. Not about L&D, not about the UCSD Midwives per se, not about politicized birth rhetoric, natural or not, epidural or not etc. It was a 4.5 minute piece about a specific place offering a specific option. It's one of the only places of it's kind. Why does that inspire raised hackles and rolling eyes?

Thanks Karen for clarifying some assumptions that had been made. I gave birth at the Birth Center last year, and it was great to have that - say it with me people - OPTION. The Birth Center and the midwives work seamlessly within the UCSD medical practices, and all of my health information from previous obstetrics visits was available and used by the midwives. No one pushed an agenda, and there was a lot of focus on education of the patient and their supporters.I challenge the assumption made by other commenters that "natural birth-ers" judge mothers with other types of births. I commend KPBS for highlighting a little-known program that has enriched the lives of thousands of families. All one has to do is see the photo board behind the nurses' station at the Center to see what it is all about.

We need to see more news stories about birthing options like this. Whether you personally select a drug-free birth or not, there is still a need to inform women of the choices available to them. The current pregnancy management philosophy of the ACOG/medical community does not thoroughly discuss all birthing options for healthy women and their unborn babies and access to midwives with this knowledge is often limited. So I applaud the UCSD medical center for bringing together the best of both worlds. What better place for natural birth and offering the accessibility to medical treatment if needed.

This discussion should focus on choice and education-- not on whether non-medicated births are appropriate for all mothers. I have personally experienced a drug-free labor process and support other women who focus on the human body's natural balance. But I also understand women's concerns about the expected pain of childbirth. While I had a positive experience at a hospital known for birthing babies, I may consider the birthing center at UCSD the next time around.

I'm not Big Brother; I don't feel the need to scold you like the KPBS staff did. I hope that we can remember that, just because we don't see things the same way doesn't make either one of us misinformed.

I see many comments here from people who don't have a lot of experience to back up their opinions. That's ok, I suppose, but arguments are much better made when they are well-founded.

I gave birth to my first son at UCSD Birthing Center, and I could not have been happier w/ the experience. I had been under the care of a 'traditional' Ob/Gyn, and when it came time to discuss the things *I* wanted for *my* birth, my doctor just wouldn't listen. So at 36-weeks pregnant, I switched over to the midwives at UCSD. It's one of the best decisions I've ever made.

I don't believe the article in any way stated that women who choose medication during birth are weaker than those of us who choose to deliver 'naturally.' I think the article simply stated that there are other options out there, and a local facility in San Diego has been providing those options for 10 years. They are to be congratulated.

One final comment for @Matthew, however - I am sorry your wife labored for 40 hours. I hope the outcome was a healthy baby and healthy mama.

But please understand, study after study indicates that women who are forced to lay on their backs, strapped to monitors, injected w/ "hormones" to speed up labor...these "interventions" are precisely why women end up laboring for so long, and ultimately land on an operating table.

Women need to be informed of ALL of their OPTIONS when planning their births.

You and me both. If there was anything funny about this experience, it was that I was so upset with what my wife went through, she started to tell jokes to make ME feel better. That's why she's my hero.

"I hope the outcome was a healthy baby and healthy mama."

He's the smaller and more handsome half of my avatar, as a matter of fact, and, aside from a little reminder of the ultimate procedure, she's lost all the baby weight I still have.

"But please understand, study after study indicates that women who are forced to lay on their backs, strapped to monitors, injected w/ 'hormones' to speed up labor...these 'interventions' are precisely why women end up laboring for so long, and ultimately land on an operating table."

While I share your healthy skepticism for the medical profession, this is a straw man argument. "Study after study" is a broad brush which doesn't cover every peer-reviewed medical study. Unless you can be more specific, that's too general a statement to take seriously.

It also presumes that parents like ourselves were not informed of all options. We tried to have induce labor naturally; it didn't. We tried to dialate without pain medication; no go. We tried to dialate with pain medication; still nothing. The C-section ultimately determined why; an irregular uterine thinning that, while not life-threatening, could have only been determined by surgical examination. Had we not gone the more medically conducive route, my wife would have been pushing somewhere the baby couldn't go, causing a rupture and possible death for both of them. As it was, with all of the medical professionals on the wait in a rather confortable labor & delivery room, what could have been tragic out of ideology became routine --save for th 40 hours of labor, of course.

@rlomeli, I watched that and concluded that Ricki Lake, like another certain Hollywood celebrity who has something against medicine, has an agenda.

So, she had a positive labor experience using a midwife. Good for her. That's a far cry from concluding that all medical intervention in the birth process is unnatural and sinister. It also, as I stated originally, puts another guilt trip on parents who either choose or must have medical intervention.